An effective mesiodens extraction method involving an intraoral approach through the nasal floor bone

Abstract

A mesiodens is a supernumerary tooth located in the maxillary central region, frequently found in an inverted, impacted position, which can cause delayed or ectopic eruption of the permanent incisors. Unerupted supernumerary teeth are typically removed by the traditional palatal or labial approach. However, the traditional approach may induce injury to the adjacent root or damage the surrounding soft tissue because a deeply impacted mesiodens requires excessive bone removal in the anterior maxilla. The aim of the present study was to introduce an effective tooth extraction method involving an intraoral approach through the floor bone of the nasal cavity.

Collaborative supernumerary nasal tooth extraction by nasal and intraoral approaches

“…For incompletely erupted impacted ST, an approach from the base of the nose cutting through the maxillary bone can minimize damage and ensure a safe surgery. 9 In the case of fully erupted intranasal teeth, however, extraction is typically performed endoscopically from the nasal cavity instead.…”

“…Intranasal teeth can be classified into two types: cases where the crown is completely erupted inside the nasal cavity and cases where the crown is partially erupted inside the nasal cavity. For incompletely erupted impacted ST, an approach from the base of the nose cutting through the maxillary bone can minimize damage and ensure a safe surgery 9 …”

Abordaje Transoral para la Extracción de un Diente Supernumerario Intranasal. Presentación de un Caso y Revisión de la Literatura

“…Actualmente su etiología es incierta, sin embargo, se han postulado varias teorías como traumatismos, fac-nes quirúrgicas realizadas mediante abordaje palatino, presentan mayor tasa de complicaciones respecto al abordaje vestibular. Yamamoto & Hanazawa (2019) proponen un algoritmo para recurrir al abordaje transoral basados en 3 requisitos: En primer lugar, el mesiodens debe estar inmerso bajo la cavidad nasal y en posición invertida; Segundo, el ángulo formado entre el plano palatino y el eje mayor del mesiodens debe ser mayor a 90º, de no cumplir este requisito es necesario un abordaje palatino accesorio, y por último, distancia estrecha entre la espina nasal anterior y el eje mayor del diente. Hauer et al (2019) postula que las ventajas de un abordaje transoral respecto al abordaje transpalatino es que en el primero se genera una herida de menor tamaño debido a una mínima exposición del maxilar y menor osteotomía.…”

Vertical Frenal Split for Mesiodens Removal: A Novel Technique

“…A recent study has advocated an intraoral approach through the nasal floor for removing ectopic mesiodens [10]. An incision avoiding the maxillary labial frenulum was made in the upper vestibular region, a mucoperiosteal flap was elevated towards the nasal piriform.…”